正念训练对医疗保健专业人员和学员的影响：一项随机对照试验的荟萃分析。

Mindfulness training for healthcare professionals and trainees: A meta-analysis of randomized controlled trials.

机构信息

Department of Educational and Counselling Psychology, Education Building, McGill University, 3700 McTavish St (Room 614), Montreal H3A 1Y2, QC, Canada.

出版信息

J Psychosom Res. 2019 May;120:29-38. doi: 10.1016/j.jpsychores.2019.03.003. Epub 2019 Mar 5.

DOI:10.1016/j.jpsychores.2019.03.003

PMID:30929705

Abstract

OBJECTIVE

Healthcare professionals (HCPs) experience a wide range of physical and psychological symptoms that can affect quality of patient care. Previous meta-analyses exploring mindfulness-based interventions (MBIs) for HCPs have been limited by their narrow scope regarding intervention type, target population, and/or measures, and reliance on uncontrolled studies; therefore, a more comprehensive and methodologically rigorous examination is warranted. This meta-analysis quantified the effectiveness of MBIs on distress, well-being, physical health, and performance in HCPs and HCPs-in-training.

METHOD

RCTs examining the effect of meditation and MBIs on HCPs and HCPs-in-training were identified and reviewed. Two independent reviewers extracted data and assessed risk of bias.

RESULTS

Thirty-eight studies were included in the analyses (n = 2505; 75.88% female). Intervention had a significant moderate effect on anxiety (Hedge's g = 0.47), depression (Hedge's g = 0.41), psychological distress (Hedge's g = 0.46), and stress (Hedge's g = 0.52). Small to moderate effects were also found for burnout (Hedge's g = 0.26) and well-being at post-intervention (Hedge's g = 0.32). Effects were not significant for physical health and performance. Larger intervention effects on overall outcomes were found with HCPs (Hedge's g = 0.52), with Mindfulness-based Stress Reduction intervention (Hedge's g = 0.47), and inactive controls (Hedge's g = 0.36).

CONCLUSIONS

Results suggest mindfulness-based interventions are effective in reducing distress and improving well-being in HCPs and HCP-ITs. Subgroup analyses suggest the importance of exploring potential participants' needs prior to selecting the type of mindfulness intervention. Future studies should assess changes in mindfulness and include active controls.

摘要

目的

医疗保健专业人员（HCPs）经历广泛的身体和心理症状，这可能会影响患者护理的质量。以前探索基于正念的干预措施（MBIs）对 HCPs 的荟萃分析受到干预类型、目标人群和/或措施以及对非对照研究的依赖的限制；因此，更全面和方法严格的检查是必要的。本荟萃分析量化了 MBIs 对 HCPs 和 HCPs 受训人员的困扰、幸福感、身体健康和表现的影响。

方法

确定并审查了研究冥想和 MBIs 对 HCPs 和 HCPs 受训人员影响的 RCTs。两名独立审查员提取数据并评估偏倚风险。

结果

38 项研究纳入分析（n=2505；75.88%为女性）。干预对焦虑（Hedge's g=0.47）、抑郁（Hedge's g=0.41）、心理困扰（Hedge's g=0.46）和压力（Hedge's g=0.52）有显著中度影响。干预后也发现倦怠（Hedge's g=0.26）和幸福感（Hedge's g=0.32）有小到中度影响。对身体健康和表现没有显著影响。对整体结果的干预效果较大，对 HCPs（Hedge's g=0.52）、正念减压干预（Hedge's g=0.47）和非活动对照（Hedge's g=0.36）。